Concerns about Autism & child development

Autism is a neurodevelopmental condition that affects how a person communicates, interacts with others and experiences the world. Children with autism may have differences in communication, social interaction and behavior. The exact cause of autism is not yet known, but it is believed that a combination of genetic and environmental factors are responsible for it. There is no cure for autism, but therapies, accommodations and support can help individuals with autism lead fulfilling lives.

Common concerns about Autism and child development

Listed below are the questions raised by concerned parents, and the answers delivered by Dr. Ajay Sharma. We encourage parents to post queries, should they have any, in the comments section. We will do our level best to try and get all your questions answered from the expert sources available to us.

We have also listed out common myths and misconceptions about Autism. Help us bust these myths by learning about them and spreading the word.

• Can MMR vaccination cause autism?
• At what age is autism diagnosed in a child?
• If my child has autism by virtue of genetic defects, there is little we can do as parents, to reverse those effects. In such instances, what can we as parents do, to help the child?
• What is neuroplasticity?
• My child used to say certain words at an early age but has stopped using them and has become non-speaking. With therapy, he is now starting to make babbling sounds. Can regression happen in children with autism?
• Why does regression occur in some children with autism?
• Do regulated or special diets help reduce challenges in children with autism?
• Can movement therapy like Yoga, exercise or physical activity reduce complications in autism?
• If motivating my child is key to helping him/her learn, then how does one achieve it?
• My child, who was diagnosed with autism, overcame it. He underwent academic hurdles, but was able to excel at football. So, we didn’t push him to pursue academics and concentrated on his football training. Now a teenager, my son is unable to get selected?
• Can a child with Down Syndrome also develop Autism?
• How can I support my child in managing sensory overload?
• My child is sensitive to sounds such as the whistle of a pressure cooker, but not sensitive to loud drum sounds. How is this possible?
• My child doesn’t understand sarcasm or jokes. How do I help them?
• Could you provide some tips for behavior management in children and adolescents?
• My child is calm and well-behaved the whole day, but when a family member, such as the father comes home, I notice a sudden change in behavior. Behavior traits such as head banging increase. Why is that?

Can MMR vaccination cause autism?

MMR does not cause autism. The scientific studies associating autism with vaccination have been retested and disproved since. It is possible that in children with autism who underwent vaccination, the underlying deficiencies or complexities may have been present throughout. These deficiencies may have just shown up after vaccination. The human mind easily forms associations, which can lead to a lot of confusion and anxiety among parents. It is now safe to rest the case and accept that MMR vaccination has no relationship with the development of autism.

At what age is autism diagnosed in a child?

Diagnosis of autism in children normally happens in these age groups:

1. 12-18 months: A  definitive diagnosis is possible in this age group.  Key sign for diagnosis: The child  doesn’t seem to show interest in people (by making eye contact, responding to their name, etc.).(9 months is too early to catch this delay in social communicative skills in the child)
2. 3 years – 4 years: The biggest group of diagnosed children.  Key Sign for diagnosis: The child doesn’t seem to engage in pretend play and their communication style is noticeably different from their peers.
3. 6 years:. Some children are diagnosed later when social differences become more apparent, for example, observed when playing with others.

If my child has autism by virtue of genetic defects, there is little we can do as parents, to reverse those effects. In such instances, what can we as parents do, to help the child?

Parents can help their child by carefully observing their child, and paying attention to what a child needs,  Once you have identified the concerns, try and understand what can be done to make the situation better. Remember: While genetics play a role in autism, a nurturing and supportive environment can make a meaningful difference in how a child experiences the world and express themselves. Even when the child’s developmental ability to learn anything is reduced (due to genetic defects for example), learning can be introduced to help the child by taking advantage of the brain’s capacity to learn and be flexible. This ability of the brain is referred to as neuroplasticity, details of which are shared in the next Q&A.

What is neuroplasticity?

Neuroplasticity is the ability of the brain to shape itself based on experiences. Learning and behavior can thus be shaped dynamically at any age, driven mostly by the person’s experiences. Though neuroplasticity is at its best in the early years of life (relate this to a child’s ability to learn a language much faster than an adult), the learning capacity of the brain does continue to occur, but at a reduced rate as the person grows older. Here are a few examples to better understand this process.

Examples:

1. The brain can learn sounds during the first 2 years of life. After this, the brain cannot learn new sounds. That window is closed. But the brain can still learn letters, and words or learn a new language.
2. The brain can learn accents for up to 8 years only. After that, a person’s pronunciation may be affected, and the person is no longer able to learn a different accent.
3. The timeline between birth to 4 years is a sensitive period for vision development and learning. For people who have a squint eye, the brain does not allow the affected eye to focus on one object, thus rejecting images projected by that eye. In order to bring back the ability of the affected eye, doctors put a patch and cover the good eye (initially for a couple of hours). Now, the brain is forced to use the affected eye and bring it back to work.
4. The same ability of neuroplasticity is used by physiotherapists to get a person to use their non-functional limb. Thus, the brain always remains in learning mode. Neuroplasticity works even when the door to learn something closes. To make neuroplasticity work with children, the following factors must be considered:

• Utilize a structured teaching plan for the child
• Engage the child to put in effort during the learning process
• Provide the child with motivation for learning
• Have the power of faith. Have faith in the power of your efforts.

My child used to utter certain words at a certain age, but now has stopped using those words. Gradually, he has become non-verbal. With therapy, he is now starting to make babbling sounds. Can regression happen in children with autism?

Yes, it does. It happens in 1/3rd of children with autism. This happens normally between 18 to 24 months of age. As a child develops, he/she shifts gears to higher levels of growth, progressively with age.

Why does regression occur in some children with autism?

Due to factors we are not entirely clear about, at certain times the child’s body is unable to turn on certain genes required to support higher stages of growth. As an analogy to explain regression, let us assume a child’s brain’s function requires it to turn on 3 genes at 3 months of age, and 5 genes at age 5 months and so on. For whatever reason, the genes that need to be turned on at 5 months are unable to turn on 2 of the 5 genes that control brain function. This signals the brain to revert back to the lower level of growth (from age 5 months to 3 months) where just 3 genes are sufficient and support the brain development of a child. It is the brain’s way of becoming comfortable with a lower level of gene function. Thus, children revert back to what they can work with. This shows up as regression, which is mainly due to genetic influences.

Do regulated or special diets help reduce challenges in children with autism?

Whether you want to pursue a special diet or not, remember the golden rule: never do anything that can harm your child. 

Some children may be allergic and may be sensitive to gluten/milk/lactose. The consumption of these substances may cause diarrhea or other symptoms. Under such circumstances regulating the diet can be a source of relief for the child. 

In some children, chocolates, additives/food colors or sugars may cause hyperactivity. In such instances, maintaining a food diary and making note of all the food responses of your child will help you understand the source of his/her discomfort. Use this information to identify foods that can contribute to feelings of restlessness or hyperactivity. Once identified, eliminating those specific foods may be beneficial. 

If any particular food does make a child hyperactive, then not giving those foods will not make the child less hyperactive. Thus, blindly following a specialized diet (such as  GFCF) will be less beneficial to the child’s condition. If you do make the personal choice of pursuing a special diet, do talk to a dietician and make sure the child’s special diet is balanced and healthy to ensure proper bone growth, and one that doesn’t contribute to malnutrition or vitamin deficiencies. 

Please bear in mind that changing the diet doesn’t make it less important to pursue other therapies. Even when on a diet, other therapeutic interventions must continue. As a rule, give your child 10 drops of multivitamin syrup up to 2 years of age, after which older children may be given on a requirement basis. Multivitamin drops, being one of the cheapest drugs available in the market, continue to be unused by most parents.

Can movement therapy like Yoga, exercise or physical activity reduce complications in autism?

Physical activity can support self-regulation, coordination, and overall well-being. When we pursue any physical activity our brain becomes alert and is more willing to learn new things. This makes us more responsive to any activity. As a result, the brain also wants its sensory needs met. It becomes more active and willing to learn new things in response.

If motivating my child is key to helping him/her learn, then how does one achieve it?

Here are a few ways of providing your child with motivation to learn and engage –

• Give them responsibility: E.g. Making the child the leader of a class.
• Give them opportunities to be successful. Merely an attempt at work is enough, not necessarily excelling at it.
• Reward them in response to their completed tasks.
• Help older kids set goals and explore their creativity in ways that excite them.
• If they don’t want to do a certain task then pursue them to engage in things they want to do, and then slowly build their interest to pursue the disinterested task.

My child, who was diagnosed with autism, overcame it. He underwent academic hurdles but was able to excel at football. So, we didn’t push him to pursue academics and concentrated on his football training. Now a teenager, my son is unable to get selected?

It is entirely possible the child, who is now an adolescent, is struggling with teenage issues here. Instead of pushing the child to play football, casually encourage him to engage in something else that is of his interest. Gradually, he may be able to overcome his fear of rejection and pursue his interests, whether old or new. As parents, accepting our children as they are—without expectations of past performance—can help us support them better. With time and encouragement, he may regain confidence and find a path that feels right for him. Can a child with Down Syndrome also develop Autism?

Yes, it is entirely possible. Both conditions can occur in the same child.

How do I help my child overcome sensory overload?

First, provide the child with the sensory input that is needed. Then, dedicate a separate space for the child to de-stress for 1 hour after the activity. This resting time will help the child cope with the situation better.

My child is sensitive to sounds such as the whistle of a pressure cooker, but not sensitive to loud drum sounds. How is this possible?

Children are sensitive to specific types of sounds. They may not necessarily be sensitive to the volume or ‘loudness’ of a sound.

My child doesn’t understand sarcasm or jokes. How do I make them understand?

One good way of teaching them the concept of a joke or sarcasm is by introducing social stories as a means of explanation.

Could you provide some tips for behavior management in children and adolescents?

A few key pointers that must be considered for effective behavior management –

• Focus on the reward, not the punishment.
• Discipline is most overrated. Use it wisely.
• Use affection generously.
• Firmness rather than anger is needed for behavior control.
• Follow a certain routine or structure to regulate a specific behavior.
• Appreciating the stage the child is at can help calm the child.
• Beating the child breeds fear, and fear does not have a long-standing effect. It can increase aggression and teach the child to beat others.
• Give specific instructions when instructing your child. For example – “I will be angry with you if you hit others“ “I will be angry if you cross the road (without me)” “I will be angry if you shout at kids” “I will not be angry if you stomp on the sofa”
• Follow-up after specific instructions have been handed out to the child. If they continue to pursue unwanted behavior then instruct them that they lose certain playtime privileges, such as TV or games. T
• Last but not least, you as a parent must GET OVER IT. Do not dwell on it and bring it up in conversation with the child at a later date. The child may have probably forgotten the context to begin with, and repetitions of the incident wouldn’t help with behavior management

My child is calm and well-behaved the whole day, but when a family member such as the father comes home, I notice a sudden change in behavior. Behavior traits such as head banging increase. Why is that?

There can be many reasons which might be causing this. You can refer to this Information Resource to understand behavior patterns better and how to track them: ABC Chart – Tracking Behaviour Concerns and Aiding Its Management

However, a probable reason for your child’s behavior could be that they are seeking attention or connection from a family member. Sometimes, children realize that a particular person (like a parent who is away during the day) might react differently or more leniently, and they engage in the behavior because they expect a certain kind of response.

In such cases, it’s helpful for both parents or family members to have a private discussion and agree on how to respond consistently when the behavior occurs. A uniform and predictable response from all adults can help the child feel more secure and reduce confusion or inconsistent behavior.

That said, there might be several other reasons behind such behavior changes—ranging from sensory overload, unmet needs, to communication difficulties. Observing the context and patterns, and possibly seeking professional input, can help you understand and support your child better.

If you have questions about Autism, Down Syndrome, ADHD, or other intellectual disabilities, or have concerns about developmental delays in a child, the Nayi Disha team is here to help. For any questions or queries, please contact our FREE Helpline at 844-844-8996. You can call or WhatsApp us. Our counselors speak different languages including English, Hindi, Malayalam, Gujarati, Marathi, Telugu, and Bengali.